<p> European Aviation Safety Agency Application for Export Certificate of Airworthiness for Newly Manufactured Aircraft</p><p>1. Applicant </p><p>1.1 Applicant’s Reference Internal Reference (if applicable) 1.2 Organisation Name Organisation Name</p><p>1.3 Address Address (registered business/postal address) 1.4 Contact Person Contact Person (if applicable) 1.5 Telephone Phone</p><p>1.6 Fax Fax</p><p>1.7 E-mail Email</p><p>1.8 POA approval number Manufacturer POA Number</p><p>2. Scope  Large Aircraft  Other Aircraft  Draft EASA Form 52 attached, reference number: </p><p>3. Applicability / Description</p><p>3.1 Aircraft Manufacturer Enter Aircraft Manufacturer</p><p>3.2 Aircraft Type / Model Enter Aircraft Type / Model Designation Designation</p><p>3.3 Aircraft Serial Number Enter Aircraft Serial Number</p><p>3.4 Importing State Enter State where aircraft is imported</p><p>3.5 Place E-CofA to be issued Enter location where aircraft will be transferred to customer</p><p>3.6 Application related to Not applicable ongoing certification project P-EASA. (insert P-No) number (when applicable)</p><p>4. Export Certificate of Airworthiness</p><p>4.1 Expected date of delivery Enter expected date of delivery</p><p>EASA Form 29 Application for Export Certificate of Airworthiness Page 1 of 4 for Newly Manufactured Aircraft Issue 2, dated 08/09/2010 4.2 Description of the non- Enter reference to list on draft EASA Form 52 where applicable compliance with the applicable airworthiness requirements of the importing State</p><p>4.3 Special import Enter reference to import requirements requirements</p><p>5. To be filled in only by the Agency/NAA: Statement of technical satisfaction Based on the information provided by the POA holder in the provisional EASA Form 52 and associated documentation, the E-CofA Inspector is satisfied that the applicant has shown that the product identified in paragraph 3 above, is considered to be in compliance with the type certification basis established by EASA, and with those special requirements of the importing State when filed with EASA, except as noted below: Notes/Remarks/Restrictions:</p><p>Name E-CofA Inspector Signature E-CofA Inspector Date of Signature </p><p>(dd/mm/yyyy)</p><p>6. Applicant’s declaration</p><p>I confirm that the information contained herein is correct and complete. I have accessed, read and agree to be bound by the Agency’s Terms of Payment (available here: http://easa.europa.eu/regulations/fees-and-charges-regulation.php). Accordingly, I agree to pay the fees levied by EASA in respect of the issuance of an Export Certificate of Airworthiness for Newly Manufactured Aircraft and am aware of the consequences of non-payment.</p><p>7. Signature by applicant</p><p>Date Name Signature</p><p>This Application should be sent by fax, e-mail or regular mail directly to your local E-CofA Inspector. Upon completion of the Statement of Technical Satisfaction, the E-CofA Inspector should forward this Application, together with the draft EASA Form 52, the provisional E-CofA and any supporting documentation by fax, e-mail or regular mail to: European Aviation Safety Agency Application and Procurement services Department Applications management section Manager</p><p>EASA Form 29 Application for Export Certificate of Airworthiness Page 2 of 4 for Newly Manufactured Aircraft Issue 2, dated 08/09/2010 Postfach 10 12 53, D-50452 Köln, Germany Fax: +49 – (0) 221 - 89990 ext. 4455 E-mail: [email protected] </p><p>8. Charges information</p><p>Applicants for Export Certificate of Airworthiness for Newly Manufactured Aircraft will be charged in accordance with the Commission Regulation (EC) No. 593/2007 of 31 May 2007 on the fees and charges levied by the European Aviation Safety Agency (OJ L 140, 1 June 2007, p. 3). This activity is regarded as a service within the meaning of Article 10 of the above-mentioned Regulation. According to Article 11 of the above-mentioned Regulation, the services provided by EASA give rise to charges which shall be equal to the real cost of the service provided. The real costs associated with the services are defined as follows: 1. Flat rate applicable to hours performed by EASA technical experts and /or the EASA's contractors. This flat rate is set at 6 working hours for large Aircraft related E-CofAs and 2 working hours for other E-CofAs. 2. Travel costs which are payable by EASA to its contractors or staff, including:  Transport costs (airplane ticket, visa costs, train, car, bus, taxi),  Travel time costs (travel time x hourly rate),  All other costs (accommodation and meals, incidental expenses and travel allowances paid to staff in the context of those activities) which are payable by EASA to its contractors or staff. These costs are recovered with the standard rate “per diem”. The applicable hourly rate is defined in Part II of the Annex of the above-mentioned Regulation. In the case of withdrawal of the application, or other cases of interruption that qualify under Article 8(7) of Regulation 593/2007, EASA will recover any fees due, calculated on an hourly basis but not exceeding the applicable fee. EASA will also recover any travel costs incurred.</p><p>DO NOT FORGET TO SIGN THE APPLICATION FORM</p><p>EASA Form 29 Application for Export Certificate of Airworthiness Page 3 of 4 for Newly Manufactured Aircraft Issue 2, dated 08/09/2010 Information to be entered into Form 29 - Application for Export Certificate of Airworthiness for Newly Manufactured Aircraft:</p><p>The use of this form is required to enable EASA to process applications without undue delay. The individual fields of the application form may be varied in size to allow entry of all required information. It is strongly recommended to use the English language. </p><p>Field 1.1: enter your reference (optional) </p><p>Field 1.2: enter the name of the legal entity making the application </p><p>Field 1.3: enter registered business address to be printed on the certificate; add postal address if different e.g. for mailing or billing purposes </p><p>Field 1.4-1.7: enter name, telephone, fax and e-mail of contact person for this application</p><p>Field 1.8.: enter reference to POA approval</p><p>Field 2: in case of Export Certificate of Airworthiness for Newly Manufactured Aircraft for Large Aircraft tick the dedicated box for the category of aircraft and identify the draft EASA Form 52 reference number</p><p>Field 3.1-3.3: enter manufacturer, type / model, serial number</p><p>Field 3.4: enter State where aircraft is imported</p><p>Field 3.5: identify the location where the aircraft will be transferred to the customer</p><p>Field 3.6: if the application for Export Certificate of Airworthiness for Newly Manufactured Aircraft is related to an ongoing certification project that has already been applied for, tick the dedicated box and insert the complete EASA project number (P-No)</p><p>Field 4.1: identify the expected date of delivery of the aircraft</p><p>Field 4.2: give a short description of the non-compliance with the applicable airworthiness requirements of the importing State</p><p>Field 4.3: identify specific importing State requirements</p><p>Field 5: to be filled in only by the Agency/NAA</p><p>Field 7: signature of an authorised representative of the applicant</p><p>EASA Form 29 Application for Export Certificate of Airworthiness Page 4 of 4 for Newly Manufactured Aircraft Issue 2, dated 08/09/2010</p>